2020 TUA Faculty Advisors Certification of New Membership Form

(Insignia) NATIONAL ORGANIZATION FOR HUMAN SERVICES TUA UPSILON ALPHA NATIONAL HONOR SOCIETY “τελειότητα στην υπηρεσία στην ανθρωπότητα Excellence in Service to Humanity TUA CHAPTER CERTIFICATION OF NEW MEMBERS FORM This form must be signed by the TUA Chapter Faculty Advisor verifying all members’ eligibility and attesting to the fact that each named member has met the minimum standards for membership in Tau Upsilon Alpha TUA Chapter Information Date Submitted:       Chapter (Greek name given by National Headquarters):      Name of College/University:       Advisor’s Name:       Phone: (     )       Email:       Induction Date:       (If no induction date is given, we will use the date this form was submitted) Certificates will be mailed to Attention to:       Name of College/University:       Address:       City:       State:       Zip:       Helpful Tips: To fill in this form, please use the tab or arrow keys to get to each field or use your mouse to place the cursor on the field you want to type into The grayed fields will expand to accommodate your information In order to keep a clean copy of this document select Save As…from the file menu and type in your choice of file name Your typing will then be safe in your new document Lifetime Membership Fees Total number of Lifetime Membership Fees:       @ $40.00 = $      Total fees enclosed All payments must be in the form of a college/university check, chapter check, cashier’s check or money order made payable to NOHS No applications will be accepted via email Pay online at www.nationalhumanservices.org and upload completed and signed application or mail the completed and signed application with the payment indicated above to: Tau Upsilon Alpha Honor Society c/o NOHS 147 SE 102nd Avenue - Portland, OR 97216 I certify that all the individuals listed on this form have provided all information required, have paid their initiation fee and have attained the criteria required by Tau Upsilon Alpha, National Organization for Human Services Honor Society in order to be inducted NOHS * TUA National Honor Society * c/o NOHS * 147 SE 102nd Avenue, Portland, Oregon 97216 * http://www.nationalhumanservices.org/tua-home TUA CHAPTER CERTIFICATION OF NEW MEMBERS FORM Page of Faculty Advisor’s Signature: Date:      NOHS * TUA National Honor Society * c/o NOHS * 147 SE 102nd Avenue, Portland, Oregon 97216 * http://www.nationalhumanservices.org/tua-home TUA CHAPTER CERTIFICATION OF NEW MEMBERS FORM Page of NEW CHAPTER MEMBER INDUCTEES Full Name as to appear on membership certificate       Degree Level Type of Membership select one select one Associate Student GPA Contact Information As on Official Transcript GPA:       If Student, Expected date of Graduation: Address:      City:      State:      ZIP:      Email:            Phone:(     )      Phone:(     )            Associate Student GPA:       If Student, Expected date of Graduation: Address:      City:      State:      ZIP:      Email:            Phone:(     )      Phone:(     )            Associate Student GPA:       If Student, Expected date of Graduation: Address:      City:      State:      ZIP:      Email:            Phone:(     )      Phone:(     )            Associate Student GPA:       If Student, Expected date of Graduation: Address:      City:      State:      ZIP:      Email:            Phone:(     )      Phone:(     )            Associate Student GPA:       If Student, Expected date of Graduation: Address:      City:      State:      ZIP:      Email:            Phone:(     )      Phone:(     )            Associate Student GPA:       If Student, Expected date of Graduation: Address:      City:      State:      ZIP:      Email:            Phone:(     )      Phone:(     )            Associate Student If Student, Expected date of Graduation: GPA:       Address:      City:      State:      ZIP:      NOHS * TUA National Honor Society * c/o NOHS * 147 SE 102nd Avenue, Portland, Oregon 97216 * http://www.nationalhumanservices.org/tua-home TUA CHAPTER CERTIFICATION OF NEW MEMBERS FORM Page of       Email:      Phone:(     )      Phone:(     )            Associate Student GPA:       If Student, Expected date of Graduation: Address:      City:      State:      ZIP:      Email:            Phone:(     )      Phone:(     )            Associate Student GPA:       If Student, Expected date of Graduation: Address:      City:      State:      ZIP:      Email:            Phone:(     )      Phone:(     )      10       Associate Student GPA:       If Student, Expected date of Graduation: Address:      City:      State:      ZIP:      Email:            Phone:(     )      Phone:(     )      11       Associate Student GPA:       If Student, Expected date of Graduation: Address:      City:      State:      ZIP:      Email:            Phone:(     )      Phone:(     )      12       Associate Student If Student, Expected date of Graduation:       GPA:       Address:      City:      State:      ZIP:      Email:      Phone:(     )      Phone:(     )      NOHS * TUA National Honor Society * c/o NOHS * 147 SE 102nd Avenue, Portland, Oregon 97216 * http://www.nationalhumanservices.org/tua-home ... http://www.nationalhumanservices.org /tua- home TUA CHAPTER CERTIFICATION OF NEW MEMBERS FORM Page of NEW CHAPTER MEMBER INDUCTEES Full Name as to appear on membership certificate       Degree Level Type of Membership select.. .TUA CHAPTER CERTIFICATION OF NEW MEMBERS FORM Page of Faculty Advisor’s Signature: Date:      NOHS * TUA National Honor Society * c/o NOHS... NOHS * TUA National Honor Society * c/o NOHS * 147 SE 102nd Avenue, Portland, Oregon 97216 * http://www.nationalhumanservices.org /tua- home TUA CHAPTER CERTIFICATION OF NEW MEMBERS FORM Page of